Abstract
Dear Editor,
I found the article by Ai, Noël, Appel, Huang, and Hefley (2012) to have the potential to contribute significantly to our understanding about the overall health and health care utilization among Latino men in the United States. The findings advance the field by using a well-described survey of Latinos who participated in the National Latino and Asian American Study to cross-sectionally identify differences among Cuban Americans, Mexican Americans, Puerto Ricans, and other Latinos. The authors provided an insightful discussion about potential explanation for the differences between subgroups of Latinos in the United States and variability according to place of birth. The methods describe the variables Birthplace as foreign-born and U.S.-born; and years in the United States was categorized into 0 to 5, 6 to 10, 11 to 20, and 21 years, with U.S.-born participants assigned the highest score to avoid missing values. This is followed by the sentence: “The average time in the United States was.” This seems to be a minor comment about an incomplete sentence. While confirmatory, the study found that “Puerto Rican American” men had higher rates of 8 out of 15 physical ailments.
There is, however, a more serious error in the data analysis and data reporting. The term Puerto Rican American is wrongly constructed, poorly justified, and politically incorrect. Puerto Rico is a commonwealth of the United States, and as such they are all citizens of the United States. Thus, all Puerto Ricans are Americans regardless of place of birth and can travel freely between the island of Puerto Rico and other parts of United States. While speculative, the same rationale used by the authors would dictate that people who were born in Hawaii or Alaska can only be considered American if they were born in the continental United States. Therefore, the authors should restrain from labeling Puerto Ricans who were born in the island of Puerto Rico as foreign-born. This type of statement lacks cultural sensitivity. These are not shortfall of the data set but assumptions made in interpreting the data. The unique contribution of this article is that it can identify patterns of health behavior among Latino men and potential difference by subgroups; however, in its current form it fails to properly take into account the Puerto Rican historical reality and misguide readers into thinking that there are two types of Puerto Rican men by virtue of their place of birth.